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Jurnale medicale
Emergency Medicine Journal current issue
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Jurnale medicale Emergency Medicine Journal current issue

20 Ianuarie 2015 11:32
Editor's choice: Initial validation of the International Crowding Score in Emergency Departments

As I wrote in my inaugural editorial last January, emergency medicine shares a common set of challenges regardless of where you practice, and ED crowding is one of the biggest.

In 2012, a Delphi study

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Emergency Medicine Journal current issue
20 Ianuarie 2015 11:32

In the UK, medical education and practice are regulated by the General Medical Council. This ensures that new graduates have the capabilities expected by employers and patients, and continue their career in line with the principles of good practice. The regulatory guidelines are tailored to a career

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Emergency Medicine Journal current issue
20 Ianuarie 2015 11:32
Objective

Paediatric myocarditis has remained a diagnostic challenge. We aim to identify distinct characteristics and derive a scoring system that will trigger further investigations to be performed among paediatric patients presenting to the emergency department (ED) with clinically suspected myoca

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Emergency Medicine Journal current issue
20 Ianuarie 2015 11:32

Best Evidence Topic Reports (BET) summarise the evidence pertaining to particular clinical questions. They are not systematic reviews but rather contain the best (highest level) evidence that can be practically obtained by busy practising clinicians. The search strategies used to find the best evid

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Emergency Medicine Journal current issue
20 Ianuarie 2015 11:32

A 41-year-old man with a 4-year history of maintenance haemodialysis presented to the emergency department with painful disability of his right arm after a falling accident from 3-step stairs. Physical examination revealed local swelling, deformity and tenderness of the right arm. Radiography demons

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Emergency Medicine Journal current issue
20 Ianuarie 2015 11:32

A 20-year-old builder presented to casualty with a moderately painful red right eye. On further enquiry, a clean nail had been thrown at him resulting in direct impact to his right globe. The entire nail was recovered after the injury. His visual acuity was normal at 6/5 in each eye. Inspection reve

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Emergency Medicine Journal current issue
20 Ianuarie 2015 11:32
Objective

To investigate factors associated with emergency physician perception of the shift and to determine whether these perceptions were predictors of overall daily emergency department (ED) performance indicators.

Methods

This was an observational study conducted at an inner city ED in New Sou

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Emergency Medicine Journal current issue
20 Ianuarie 2015 11:32

An 80-year-old man who was warfarinised for atrial fibrillation presented to the emergency department following a simple trip up a curb. There was no loss of consciousness. It was noted on scene that his right eye was starting to protrude and that his vision was rapidly deteriorating.

On arrival in

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Emergency Medicine Journal current issue
20 Ianuarie 2015 11:32

Traumatic aortic rupture (TAR) is a rare but serious injury, leading to death at the scene in most cases. Between 1990 and 2003, all consecutive patients and victims with TAR were retrospectively analysed by reviewing hospital and autopsy records. Univariate and multivariate Cox regression analyses

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Emergency Medicine Journal current issue
20 Ianuarie 2015 11:32

Traumatic wounds are a common reason for patients to attend emergency departments. There are many ways of managing these wounds from glue to suturing. The authors conducted a patient survey to identify the outcome measures most important to patients after closure of traumatic wounds. The results sho

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Emergency Medicine Journal current issue
20 Ianuarie 2015 11:32
Objective

To investigate whether the routine performance of urinalysis in patients with a blunt trauma mechanism is still valuable.

Methods

Consecutive patients aged ≥16 years, admitted to a Dutch Level 1 trauma centre between January 2008 and August 2011, were included in this retrospective cohort

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Emergency Medicine Journal current issue
20 Ianuarie 2015 11:32

A 44-year-old man presented to the emergency department with a 4-month history of worsening exertional dyspnoea which coincided with the development of skin lesions overlying a tattoo which he had for 7 years on his right leg (figure 1). Chest examination revealed fine crepitations on lung bases.

Bi

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Emergency Medicine Journal current issue
20 Ianuarie 2015 11:32
Background

Inadequate handover in emergency care is a threat to patient safety. Handover across care boundaries poses particular problems due to different professional, organisational and cultural backgrounds. While there have been many suggestions for standardisation of handover content, relatively

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Emergency Medicine Journal current issue
20 Ianuarie 2015 11:32
Background

Overcrowding of emergency departments (EDs) adversely affects the delivery of emergency care and results in increased patient mortality.

Objective and methods

To examine what contributes to the ED crowd and to specifically examine the patient associated population. The ED in which the re

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Emergency Medicine Journal current issue
20 Ianuarie 2015 11:32
Objective

For the early recognition and management of hypovolaemic shock, ATLS suggests four shock classes based upon an estimated blood loss in percent. The aim of this study was to assess the confidence and acceptance of the ATLS classification of hypovolaemic shock among ATLS course directors and

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Emergency Medicine Journal current issue
20 Ianuarie 2015 11:32
Objective

To quantify the rate of preventable duplication of imaging studies in the Emergency Department. Previously, to estimate potential savings from the Health Information Exchange, figures used to be based on expert opinion, as the actual rate of redundant imaging is unknown.

Materials and met mai mult
Emergency Medicine Journal current issue
20 Ianuarie 2015 11:32

A shortcut review was carried out to establish whether tranexamic acid improves outcomes for patients with life-threatening haematuria. Sixteen papers were found in Medline using the reported searches, of which four presented the best evidence to answer the clinical question. The author, date and co

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Emergency Medicine Journal current issue
20 Ianuarie 2015 11:32
Introduction

Emergency department (ED) crowding is recognised as a major public health problem. While there is agreement that ED crowding harms patients, there is less agreement about the best way to measure ED crowding. We have previously derived an eight-point measure of ED crowding by a formal co

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Emergency Medicine Journal current issue
20 Ianuarie 2015 11:32
Background

Paracetamol poisoning accounts for just under half of all self-poisoning cases that present to hospitals in England. Treatment with acetylcysteine is routine, yet recommendations regarding its use vary internationally and have recently been revised in England and Wales.

Methods

Data on a

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Emergency Medicine Journal current issue
20 Ianuarie 2015 11:32

A 50-year-old male diver visited our emergency room for general weakness after diving. He suffered from general malaise with muscle pain and joint pain after repeated diving at a depth of about 18 m in a well for about 8 h. Type I decompression sickness (DCS) was impressed. However a CT was perform

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Emergency Medicine Journal current issue
20 Ianuarie 2015 11:32
Background

The Stroke 90 Project was implemented to reduce delays to stroke thrombolysis and involved 7 hospitals and 2 ambulance services in the Avon, Gloucester, Wiltshire and Somerset regional network. Interventions included a direct to CT (DtoCT) protocol for paramedics to transport patients dir

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Emergency Medicine Journal current issue
20 Ianuarie 2015 11:32

A shortcut review was carried out to establish whether bite blocks should be used when a laryngeal mask airway is used in the emergency department. Eighteen papers were found using the reported searches and a further eight were found by scanning the reference lists. Ten presented the best evidence t

mai mult
Emergency Medicine Journal current issue
20 Ianuarie 2015 11:32
Background

Hospital prealerting in acute stroke improves the timeliness of subsequent treatment, but little is known about the impact of prehospital assessments on in-hospital care.

Objective

Examine the association between prehospital assessments and notification by emergency medical service staff

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Emergency Medicine Journal current issue
20 Ianuarie 2015 11:32
Introduction

Patients’ gender remains a contributor for bias in pain management. Implementation of standardised analgesic protocols has been shown to minimise bias in analgesic care. The purpose of this study was to assess whether gender-related bias in pain management exists in our emergency depart

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Emergency Medicine Journal current issue
20 Ianuarie 2015 11:32

The ambulances can't offload, the minor's patients are agitating for attention, the nurses are frazzled, the managers are worried and the resuscitation room has the same patients waiting hours and hours for an intensive care unit bed.

Crowding in emergency departments is one of the leading problems

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Emergency Medicine Journal current issue
20 Ianuarie 2015 11:32
Objective

We performed a systematic review of the literature to compare the efficacy of different drug therapies for the termination of stable, monomorphic ventricular tachycardia (VT).

Methods

We searched EMBASE, MEDLINE and Cochrane for trials from 1965 through July 2013 using a search strategy d

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Emergency Medicine Journal current issue
20 Ianuarie 2015 11:32

A woman presented with left wrist pain. The patient was the restrained driver in a motor vehicle accident. On examination, there was tenderness along the ulnar aspect of the distal forearm. Radial pulses were palpable, and motor and sensory examinations were intact. Radiographs were obtained (figure

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Emergency Medicine Journal current issue
15 Decembrie 2014 12:34

A male jail inmate in his 30s presented to the emergency department with shortness of breath after sustaining multiple shocks from a conducted electrical weapon (CEW). His exam revealed normal vitals, crepitus of the upper chest and neck and barb wounds on the abdomen, chest and anterior neck, 2 cm

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Emergency Medicine Journal current issue
15 Decembrie 2014 12:34
Background

Many health systems across the globe have introduced arrangements to deny payment for patients readmitted to hospital as an emergency. The purpose of this study was to develop an exploratory categorisation based on likely causes of readmission, and then to assess the prevalence of these d

mai mult
Emergency Medicine Journal current issue
15 Decembrie 2014 12:34

Best Evidence Topic reports (BETs) summarise the evidence pertaining to particular clinical questions. They are not systematic reviews, but rather contain the best (highest level) evidence that can be practically obtained by busy practicing clinicians. The search strategies used to find the best ev

mai mult
Emergency Medicine Journal current issue
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